Organization
FARIBAULT HEALTH CARE LLC
Active
Other names
St Lucas Care Center
Organization subpart
No
Provider details
NPI number
Authorized official
MR. BRADLEY ROBERT MOLGARD LCNHA (ADMINISTRATOR)
(507) 332-5100
Entity
Organization
Contact information
Practice address
500 1ST ST SE, FARIBAULT, MN 55021-6346
(507) 332-5100
(507) 332-5188
Mailing address
500 1ST ST SE, FARIBAULT, MN 55021-6346
(507) 332-5100
(507) 332-5188
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
329214
MN
314000000X
Skilled Nursing Facility
Primary
329250
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
470618800
—
MN
Enumeration date
08/23/2005
Last updated
01/28/2009
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